Objective : To analyze the status of glucose metabolism in obese children． Methods : 266 cases of obese children were included in the study，fasting plasma glucose ( FPG) ，fasting insulin ( FINS) ，glycosylated hemoglobin ( HbA1c) were measured ，Oral glucose tolerance test ( OGTT) and insulin release test ( IRT) were carried out，insulin resistance index ( HOMA-IR) ，quantified insulin sensitivity index ( QUICKI) and peak insu- lin /fasting insulin (Ip / I0 ) were calculated．Two hundred non-obese healthy children were used as control group， and glucose metabolism indexes were compared between the two groups． Glucose metabolism indexes and the incidence of insulin resistance (IR) were compared in children with different degrees of obesity ．Prediabetes risk factors and body mass index(BMI) correlation were analyzed in obese children. Results : The proportion of predia- betes and type 2 diabetes mellitus in obese children was 18. 0% (48 /266) ．FINS，HOMA-IR and HbA1c in obesi- ty group were higher than those in the control group，but QUICKI was lower than that in the control group (P < 0. 05) ．There was no significant difference in FPG between the two groups (P = 0. 423) ．FINS and HOMA-IR of severe obesity group were higher than those of mild to moderate obesity group，Ip / I0 was lower than that of mild to moderate obesity group (P＜0. 05) ，and there was no significant difference in FPG，QUICKI，HbA1c and 2hPG of severe obesity group．There was no significant difference in IR incidence between mild to moderate obesity group and severe obesity group (P = 0. 163) ．Logistic regression indicated that BMI and acanthosis nigricans was great influential on prediabetes with no statistical significance(P＞0. 05) ．Correlation analysis showed that BMI had no correlation with FPG (P = 0. 160) ，but was positively correlated with FINS，HOMA-IR , 2hPG and HbA1c (P < 0. 05) ，and negatively correlated with QUICKI and Ip / I0 (P＜0. 05) ． Conclusion Abnormal glucose metabolism is available in nearly 20% of obese children．The prevalence of insulin resistance in obese children is not affected by the degree of obesity.

Myocardial fibrosis （MF） is a common pathological manifestation of various heart diseases. Due to the non-renewable nature of myocardial cells， the occurrence of MF represents irreversible damage to the myocardium. Previous studies have suggested that fibroblast-mediated collagen deposition is the main mechanism of MF. Recent studies have found that there is an immune regulation mechanism in the heart itself， and macrophage activation/polarization plays an important role in MF. With the deepening of traditional Chinese medicine research， scholars have found that traditional Chinese medicine can interfere with MF by regulating the renin-angiotensin-aldosterone system （RAAS） system and the inflammatory process， repairing the extracellular matrix， managing oxidative stress， and maintaining the balance of autophagy. This process is closely related to the activation and M1/M2 polarization of macrophages. Throughout the MF process， macrophage activation is beneficial， but excessive activation will be harmful. In the early stage of MF， appropriate M1 macrophage polarization is conducive to activating immunity and removing harmful substances. In the middle and late stages of MF， appropriate M2 macrophage polarization is conducive to remodeling the damaged myocardium. If macrophage activation is excessive/insufficient， or the balance of M1/M2 macrophage polarization is broken， the effect changes from improvement to destruction. Traditional Chinese medicines that regulate the activation/polarization of macrophages have the effects of replenishing Qi and nourishing Yin， as well as regulating Qi and activating blood， but there are also some heat-clearing， dampness-drying， and detoxification products. Therefore， the occurrence of MF may be caused by Qi and Yin deficiency， damp heat accumulation， and Qi stagnation and blood stasis. By summarizing the biological processes involved in macrophage activation/polarization in MF， this paper expounded on the research progress of traditional Chinese medicine in regulating macrophage activation and M1/M2 polarization from different angles to improve MF， so as to provide a reference for the treatment of MF with traditional Chinese medicine.